Acute kidney injury following cardiac surgery: role of perioperative blood pressure control.

Published

Journal Article (Review)

BACKGROUND/AIMS: Patients who develop acute kidney injury (AKI) after cardiac surgery continue to have a high mortality rate. Although factors that predispose to postoperative renal dysfunction have been identified, this knowledge has not been associated with a substantial reduction in the incidence of this serious adverse event. METHODS: This review uses the existing literature to explore the relationship between AKI and perioperative blood pressure (BP) control in cardiac surgery patients. The results of recent novel analyses are introduced, and the implications of these studies for the management of cardiac surgery patients in the perioperative period are discussed. RESULTS: Preexisting isolated systolic hypertension and wide pulse pressure increase the risk of postoperative renal dysfunction in the cardiac surgery population. New data suggest that BP lability (i.e., BP excursions outside an acceptable physiologic range) during cardiac surgery may also be an important predictor of subsequent renal dysfunction. CONCLUSION: Recently published data suggest that perioperative BP lability influences both the risk of postoperative renal dysfunction and 30-day mortality. Future studies will determine whether the use of agents that allow improved BP control within a desirable range will reduce the incidence of postoperative AKI in cardiac surgery patients.

Full Text

Duke Authors

Cited Authors

  • Weir, MR; Aronson, S; Avery, EG; Pollack, CV

Published Date

  • 2011

Published In

Volume / Issue

  • 33 / 5

Start / End Page

  • 438 - 452

PubMed ID

  • 21508632

Pubmed Central ID

  • 21508632

Electronic International Standard Serial Number (EISSN)

  • 1421-9670

Digital Object Identifier (DOI)

  • 10.1159/000327601

Language

  • eng

Conference Location

  • Switzerland